Cultural Competency - Multicultural Health Generalizations: Illness
Albanian Illness and Healing Beliefs
- Illness is a cause of great concern for the patient's whole family. Extended family and kin are usually alerted and ready to help. Visitors come often to the hospital, bringing in food (viewed as a gift for healing) and a lot of attention.
- An Albanian patient may believe that illness is caused by unfavorable climate conditions, not eating the right food, or physical or psychological oppression.
- He/She may reduce the importance of "self", so as to focus on his/her family or nation overcoming a tragedy. Therefore, explaining the importance of taking an active role in the healing process may be helpful.
- An Albanian patient may expect to need medication in order to become healthy. He/She may also believe that intramuscularly administered medications have better results than orally administered medications.
- A sick patient may prefer sponge baths rather than daily baths or showers and may not wash his/her hair as frequently for fear of catching a cold or getting a headache.
- Furthermore, a patient may believe that draft can cause illness; hence, keeping the room warm and windows shut.
Source: Staff Development Group, Patient and Family Education Committee. (2004, April). Culture clues: Communicating with your Albanian patient. (Online). University of Washington Medical Center. Retrieved on July 13, 2005 from http://depts.washington.edu/pfes/pdf/AlbanianCultureClue4_05.pdf
Hindu Cultural Responses to Health and Illness
- The sick role is assumed without any feeling of guilt or ineptness in doing one's tasks. Because of strong family and kinship ties, the sick role is well accepted. The individual is cared for and relieved of responsibilities for that time.
- Also because of strong family ties and joint and extended families, Hindus are not likely to use long-term care facilities.
- Because of religious beliefs of karma, Hindus may attempt to be stoic and may not exhibit symptoms of pain. Furthermore, pain is attributed to God's will, the wrath of God, or a punishment from God and is to be endured with courage. As a result, healthcare providers may want to rely more on the nonverbal aspects of pain.
- The practice of self-medicating may mask disease symptoms until the health condition is at a more advanced stage, making treatment regimens more complex.
- Some Hindus might have a fatalistic attitude about illness causation.
- Because of the stigma attached to seeking professional psychiatric help, many Hindus do not access the healthcare system. Instead, family and friends seem to be the best help and a general belief is that time is the best healer.
Source: Purnell, L. D., & Paulanka, B. J. (1998). Transcultural Health Care: A Culturally Competent Approach. Philadelphia, PA: F. A. Davis Company.
Serious or Terminal Illness & Russians
With some Russian patients, the family members may need to be notified first - before telling the patient about his/her terminal or serious illness. The family can then decide whether or not to tell the patient of his/her condition and prognosis. Family members do not want the patient to worry and be anxious about his/her terminal illness, adding yet another burden. The family's intention is for the patient to be at peace, so physical and emotional conditions do not worsen.
Source: Lipson, J.G., Dibble, S.L., and Minarik, P.A. (Eds.) (1998). Culture & Nursing Care: A Pocket Guide. California: UCSF Nursing Press.
SFRY Health Beliefs
The following health beliefsmay apply to some people from the former Socialist Federal Republic of Yugoslavia (SFRY).
- Patients may be likely to want detailed explanations of tests and procedures.
- Treatment may not be considered complete without medication.
- The sick person may carry high status and may be encouraged to communicate about suffering.
- Some patients may have a fear of serious disease - approaching phobia.
- Health providers may be expected to give high significance to discussions of symptoms and complaints.
- Relatives might play an important role by giving moral and physical support.
The SFRY was formed in 1945 and comprised the states of Bosnia- Herzegovina, Croatia, Macedonia, Montenegro, Serbia and Slovenia.
Source:SFRY: A Guide for Health Professionals, Cultural Diversity, Queensland Government Queensland Health (Australia). http://www.health.qld.gov.au/multicultural/cultdiv/sfr_yugo.asp
Russians and Causes of Illness
- Some Russians may be concerned with staying warm, and have a fear of cold temperatures, because they feel cold could cause illness.
- Russian patients may resist a health care provider's suggestion to ice a sore part of their body.
- When Russian patients get the flu, they might blame it on exposure to a draft rather than on exposure to a virus.
- One common Russian remedy for colds and flu is the use of "bonki". Glass cups are pressed on a sick person's back and shoulders to ease fever and flu symptoms, often leaving behind bruises and welts. Such practices have been misinterpreted as abuse.
Source: St. Elizabeth Family Medicine Residency Program. ALANA Culture Center, Colgate University, Hamilton, NY
http://offices.colgate.edu/alana-cultural-center/communityservice/utica/cultures/russian/belief_practice.htm (disabled) (2004, Apr. 26)
Buddhist Beliefs of Suffering and Illness
- According to Buddhist tradition, an unclear mind produces suffering and bad karma (law of cause and effect), leading to repeated reincarnations in unsatisfactory worlds.
- Relief from suffering and unsatisfactory reincarnations can be obtained by following the Noble Eightfold Path - a practical guide requiring the development of three concepts: 1- wisdom, 2- ethical conduct, and 3- mental discipline.
- Eight highly interdependent principles encompassing these concepts are:
- Wisdom -
1. Right Understanding
2. Right Thought
- Ethical conduct -
- Mental discipline -
6. Right Effort
7. Right Mindfulness
8. Right Concentration.
3. Right Speech
4. Right Action
5. Right Livelihood - Wisdom -
- The central focus of most Buddhist practices is the achievement of a clear and calm state of mind, undisturbed by worldly actions and full of compassion.
- Illness is believed to be an unavoidable consequence of actions in this or a previous life; in other words, it may be the result of karma.
- Illness is not considered to be a consequence of punishment by a divine being, but rather a physical state that may be healed and restored through the achievement of spiritual peace and freedom from anxiety.
Sources:
Minarik, P. A. (1996). Buddhist. Culture and Nursing Care: A Pocket Guide. San Francisco: University of California.
Buddhism. The Four Noble Truths, The Eightfold Path. About. (Online). http://buddhism.about.com/library/bleightpath.htm (2004, Aug. 16)
Oriental Philosophy. Philosophy 312: Oriental Philosophy Buddhism: The Eightfold Path. Phylosophy.lander.edu. (Online) http://philosophy.lander.edu/oriental/eightfold.html (2004, Aug. 16)
Polish Women and Breast Cancer
A study conducted by the National Breast Cancer Center in 1997 explored Polish women's needs of support and information regarding breast cancer. Women with and without breast cancer were participants in the study. Issues such as options for support and information strategies were researched. Polish women without breast cancer felt that women would be more in control after a diagnosis if they had access to information in Polish about all aspects relating to the disease (diagnosis, tests, surgery, recovery, and follow-up care). They also expressed the importance of being encouraged by other Polish women with experience of breast cancer, as another option for support. Support for Polish women with cancer, however, was most likely to come from friends and family. Some information strategies supported by Polish women with breast cancer included the importance of written information in Polish and timing of reading this information. Many Polish women believe materials in Polish should be provided and personal contact in information provision should also be included. Women noted that having written information in Polish during times of stress, even for those who could read English, would be more comfortable to read since Polish is their first language. Timing of reading this information, also part of the information strategy, was important because many women in the study were not ready to immediately read about breast cancer in detail following their diagnosis. In sum, learning about Polish women's needs for support and information can promote health care providers' awareness, thus promoting measures for more effective treatments.
Source: Brushin, B., González, M., and Payne, R. (1997). Exploring cultural attitudes to breast cancer: Towards the development of culturally appropriate information resources for women from Greek, Italian, Arabic and Polish speaking backgrounds: executive summary. (Online). National Breast Cancer Center. http://www.nbcc.org.au/pages/info/resource/nbccpubs/cultatt/execsumm.htm (disabled) (2002, Jul. 1)
Redirected to: http://www.nbcc.org.au/bestpractice/resources/CA1_culturalissues.pdf
African-American Illness Beliefs
Some African-Americans may have some of the following illness beliefs:
- Causes of physical illness:
- Natural causes
- Improper diet and eating habits
- Exposure to cold air/winds
- Supernatural causes: God's punishment for improper behavior or not living according to God's will
- Home and folk remedies:
- Teas, herbs, warm medicated compresses to the chest for colds
- Advice/prescriptions from folk healers who are stable, respected and powerful resources
Source:
Locks, S. and Boateng, L.A. Black/African Americans. In Lipson, J.G., Dibble, SL and Minarik, P.A., eds. (1996). Culture and Nursing Care: A Pocket Guide. San Francisco, CA: University of California San Francisco Nursing Press.
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